Anxiety

The ABC’s of Panic Attacks: How to Empower Yourself

By Arianne MacBean

Many clients come to therapy because they experience panic. Panic, or intense anxiety, can show up in the most random places and moments. You’re sitting there, doing your thing, and then suddenly you feel dizzy, your heart races, you feel nauseous, and a sense of doom overtakes you. This is panic, and it can feel overwhelming. However, there are three steps you can take to understand, manage, and re-ground yourself if you find yourself in the throes of an episode.

Panic attacks are a way your body deals with fear.

Before we get to the ABC’s of how to deal with panic, it’s important to understand that panic is a way your body deals with fear, and it is a natural survival mechanism. In a way, panic is your body trying to help you. You’ve probably heard of the flight, flight, freeze responses that all animals have when they are faced with something that threatens them. These innate responses say that when the animal is frightened, they should either engage aggressively, run away, or hide. Fight, flight, and freeze are tools that keep animals alive.

You can ease out of panic attacks.

When a human animal experiences panic, it’s the same thing. Panic in a human is saying, “You’re scared, and you need to do something about it.” But why do we experience panic when we’re just sitting on the couch? Because life is complicated for human animals, and we have many kinds of micro and macro threats that we experience over a lifetime. Those threats become recorded into the body and, especially if we do not process them, they can show up unannounced to remind us that we do indeed need to deal with them. In this way, panic is a reminder that we have some fear that needs to be processed. This is why so many clients come to therapy – to deal with these unconscious fears. So, when you’re not in the therapy office processing emotions in a safe space with a caring advocate, how can you soothe yourself out of panic?

The ABC’s of Panic Attacks: 3 ways to recover

A. Acknowledge.

It’s vital that when you begin to experience panic that you acknowledge what is going on and that the panic is not YOU, but a feeling you have. Acknowledging panic can look like saying to yourself, “You’re feeling panic. Panic is just your body telling you to pay attention.” You can remind yourself that panic is an energy in your body that will pass soon. Our instinct when we feel panic is to distract ourselves from the discomfort and focus on something else, but like most emotions, being with the feeling will help you move through it more productively than ignoring it. Dealing with, and acknowledging panic, is the one of the best cures for it.

B. Breathe.

Focusing on your breath really is the trick to calming panic. A simple slow inhale through the nose and a long, controlled exhale through the mouth is always a great technique. If you watch any great baseball slugger at bat, you will see them use this method to calm themselves under pressure. If you want to try something a little more structured, you can inhale for a count of three, and exhale for a count of five. Lengthening the exhale will activate your parasympathetic nervous system, which controls how the body relaxes.

C. Center.

Centering is a way to re-orient yourself back to the here and now. A great way to center is to look around and notice three things in the environment around you. When your eyes fall on, let’s say, a bookshelf, really look at it. Notice the spines of the books, the colors of covers, the sheen of the wooden shelf. Then, let your eyes wander to another thing in your field of vision. Focus on it, see the details, textures, as if you’re looking at it for the first time. This will help bring you to the safety of the moment. It will help you see that you are not under attack.

As much as panic can feel engulfing, it is not entirely out of your control. Understand that panic is your body’s way of letting you know you have feelings of fear that need to be addressed. Acknowledge that panic is an energy force moving through you. Breath to anchor yourself and calm the panicky energy. Center yourself by gently engaging with the environment around you. These ABC’s are steps you can take to befriend panic as a signal to slow down, check in with yourself, and be in the process of healing.



Further Resources for Understanding Panic:
https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Panic

https://washingtoncenterforcognitivetherapy.com/problems-treated/panic-disorder/panic-disorder-organizations/

https://www.psychologytools.com/self-help/panic-attacks-and-panic-disorder/

https://www.healthline.com/health/anxiety/best-anxiety-books#A-quick-look-at-the-13-best-books-about-anxiety

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Anxiety, Managing emotions

What is somatic psychotherapy? How body awareness restores your mind

Somatic psychotherapy is the umbrella term for methods of therapy that are rooted in the body where trauma, stress, and memory are housed. Somatic psychotherapies are based on the theory that the body holds emotion and experience. When hard-to-handle feelings and traumas are not processed, they can manifest as anxiety, panic, depression, chronic pain or illness, relational issues, self-esteem problems, grief, or post-traumatic stress disorder. Somatic methods aid in draining the power of these feelings through attunement with the body – its positions, gestures, energies, and sensations. 

Somatic Psychotherapy Modalities

There are many somatic psychotherapeutic modalities. You may have heard of some of them such as, Somatic Experiencing, Sensorimotor Psychotherapy, Eye movement desensitization and reprocessing (EMDR), Hakomi Method, Brainspotting, and plain old Mindfulness. Ultimately, the kind of somatic work that happens in the therapy room depends on the client and the therapist and can involve a wide variety of techniques, including breath work, visualizations, sensory awareness, posture tracking, guided imagery, gesture, and movement. 

Somatic Psychotherapy Exercises

Sometimes, somatic exercises are very straight forward, such as simply sending compassionate breath toward a particular part of the body that is experiencing activation. Other times, exercises are created on the spot to aid a client’s specific needs in the moment. For example, a client who struggles with low self-esteem feels they are unable to accept compliments. They might say, “Positivity just flows right through me – in one ear and out the other.” In this case, we might mindfully “build” a space in the body to hold compliments, positive feedback, and love. Then, when they hear a compliment, they can visualize the affirmation dropping into and being held compassionately in the space they created for it in their body.

Somatic psychotherapy is a way to help people feel safe in their bodies while exploring thoughts, feelings, and memories. Painful experiences live in us on a cellular level, but we can heal by restoring the body to live with vitality, ease, and joy.

Questions about Somatic Psychotherapy

  • One question I often get is, “Does somatic psychotherapy include talk therapy?” The answer is YES! Although somatic practices are body-based, talking through feelings and sensations is an essential component of the therapeutic work.
  • Another question I get is, “Do I have to dance?” And the answer is NO, not unless you want to. Like most productive therapy, somatic work is client-centered and client-lead. Together with your therapist, you decide when and how to integrate the body into the healing process.

If you choose to work with me, you can expect:

  • I will naturally return to the body in the here and now as a way to ground and understand authentic self.
  • I utilize body scanning techniques to gain awareness of where pain or emotion is located in the body.
  • I track and bring awareness to repetitive gestures or postures that align with certain memories or feelings to aid in self-knowledge.
  • I share tools for calming, centering, and releasing emotions in productive ways.
  • I gently guide clients through painful experiences while noting the accompanying physical sensations and addressing them in the moment.
  • I emphasize the body as a base to locate natural resources, strengths, and self-empowerment.

If you have interest in somatic psychotherapy and healing your body, I would love to talk with you.


Further reading on somatic psychotherapy:

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (Hardcover) by Bessel van der Kolk 

Hakomi Mindfulness-Centered Somatic Psychotherapy: A Comprehensive Guide to Theory and Practice (Paperback) by Halko Weiss 

Somatic Psychology: Body, Mind and Meaning (Paperback) by Linda Hartley 

Awakened Heart, Embodied Mind: A Modern Yoga Philosophy Infused with Somatic Psychology & Neuroscience (Kindle Edition) by Julian Walker

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Managing emotions

Constantly worrying? How to soothe rumination using somatic psychotherapy

Have you ever been driving somewhere, and a memory from the past suddenly overwhelms you and you forget where you are going? Have you ever woken up in the middle of the night and began to worry about all the things you need to do, until the thoughts take over and you cannot fall back to sleep? Or have you ever had a perfectly normal day, when all of a sudden, a negative thought creeps into your head and snowballs into a sadness that you can’t shake off? This is rumination, persistent negative thoughts that hijack our minds, interfering with normal activity.

Many clients turn to therapy because they cannot get out of their heads or worry too much. Rumination is common, normal, and most of the time, temporary. In some severe cases, it can become continuous and negatively impact daily functions. More common temporary rumination is the mind’s way of letting us know we are anxious, and we can do something to help soothe ourselves out of this state.

Do thoughts have you, or do you have thoughts?

The way I like to describe rumination is that it feels like thoughts have you, rather than you having thoughts. It’s as though your thoughts are dragging you away from your centered self. Thoughts are in control, not you. Here are a few techniques that can get you back to feeling that you are in control of where you mind goes.

1. Move your body to reduce worry

A great way to unlock ourselves from rumination is to move our awareness into our body. If you find yourself ruminating in bed while trying to fall asleep, hug your knees tightly to your chest and then alternate that position with a long, big, full-bodied stretch. You will find that you naturally inhale deeply on the stretch and exhale slowly when you crunch you knees to your chest. Do this a few times. You might even want to exhale with aahhh, shhhhhh, or hhmmm sound, which stimulates the vagus nerve system, helping to promote inner balance and relaxation. 

If you’re driving, shoulder rolls can help bring your focus to your body and you can keep both hands on the wheel! Try inhaling as you roll the shoulder forward and up, and exhaling as you roll them back and down. Try to trace the widest circle your shoulders can make. Again, you can add a sound on the exhale – and the best thing about doing this when you’re driving alone is that no one can hear you. So, make the sounds as loud and weird as you want. A sense of playfulness can also help ease our way out of obsessive thinking.

2. Touch your body to reduce worry.

If you find yourself ruminating, you can give yourself a gentle face massage, or lightly tap the tips of your fingers on your face, head, neck, chest, and shoulders. This body stimulation will aid in notifying your brain that you are safe and not in harms way. It will signal to your brain that it’s OK to relax. You can also alternating tapping your right and then left thigh, which activates your right and left brain, aiding in re-orienting and unhooking from repetitive thinking.

3. Focus on your breath to reduce worry

A tried-and-true method that has helped many of my clients fall back to sleep or bring them swiftly out of a rumination episode is a ten-count visualization. This works best with eyes closed or soft inward focus, so do not do this on the road! Tune into your natural breathing rhythm. When you’re ready, visualize the number one in your mind’s eye as you exhale. Conjure the number so that you see it in front of you, almost like the number appears in your mind floating. Do this for each number all the way to ten, and then begin again with number one. This is the key – always return to one after you reach ten. Some nights, it might take three rounds before you fall sleep and others, ten or twenty. Keep at it! If you find your mind returning to intrusive thoughts let them glide by and return to your ten count visualization.

If you can’t close your eyes, but you need a breathing technique to re-center yourself after you have moved or touched your body out of rumination, a simple box breathe can help. Visualize your inhale moving up the left side of a square, extend or hold the inhale as you visualize tracing the top line of the square, exhale as you visualize tracing down the right line of the square, and extend or hold the exhale as you visualize tracing the bottom line, completing the square.

Freedom to be.

Repetitive thoughts do not have to drag us away from ourselves. They are signals that we need some reassurance, re-calibrating, and re-centering. Activating the body is a powerful way to exit the hamster wheel of obsessive thinking and anchor ourselves in the life force of breath, and just be.

-Arianne MacBean

Somatic therapy in Pasadena with Arianne MacBean, AMFT
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